Roth Alexis M, Armenta Richard A, Wagner Karla D, Roesch Scott C, Bluthenthal Ricky N, Cuevas-Mota Jazmine, Garfein Richard S
1Drexel University, Philadelphia , Pennsylvania , USA.
Subst Use Misuse. 2015 Jan;50(2):205-14. doi: 10.3109/10826084.2014.962661. Epub 2014 Oct 14.
Among persons who inject drugs (PWID), polydrug use (the practice of mixing multiple drugs/alcohol sequentially or simultaneously) increases risk for HIV transmission and unintentional overdose deaths. Research has shown local drug markets influence drug use practices. However, little is known about the impact of drug mixing in markets dominated by black tar heroin and methamphetamine, such as the western United States.
Data were collected through an ongoing longitudinal study examining drug use, risk behavior, and health status among PWID. Latent class analysis (LCA) was used to identify patterns of substance use (heroin, methamphetamine, prescription drugs, alcohol, and marijuana) via multiple administration routes (injecting, smoking, and swallowing). Logistic regression was used to identify behaviors and health indicators associated with drug use class.
The sample included 511 mostly white (51.5%) males (73.8%), with mean age of 43.5 years. Two distinct classes of drug users predominated: methamphetamine by multiple routes (51%) and heroin by injection (49%). In multivariable logistic regression, class membership was associated with age, race, and housing status. PWID who were HIV-seropositive and reported prior sexually transmitted infections had increased odds of belonging to the methamphetamine class. Those who were HCV positive and reported previous opioid overdose had an increased odds of being in the primarily heroin injection class (all P-values < .05).
Risk behaviors and health outcomes differed between PWID who primarily inject heroin vs. those who use methamphetamine. The findings suggest that in a region where PWID mainly use black tar heroin or methamphetamine, interventions tailored to sub-populations of PWID could improve effectiveness.
在注射毒品者（PWID）中，多药合用（依次或同时混合使用多种毒品/酒精的行为）会增加艾滋病毒传播风险和意外过量死亡风险。研究表明，当地毒品市场会影响吸毒行为。然而，对于以黑焦油海洛因和甲基苯丙胺为主导的市场（如美国西部）中药物混合的影响，人们知之甚少。
通过一项正在进行的纵向研究收集数据，该研究调查了注射毒品者的吸毒情况、风险行为和健康状况。采用潜在类别分析（LCA）通过多种给药途径（注射、吸烟和吞咽）确定物质使用模式（海洛因、甲基苯丙胺、处方药、酒精和大麻）。使用逻辑回归确定与吸毒类别相关的行为和健康指标。
样本包括511名大多为白人（51.5%）的男性（73.8%），平均年龄为43.5岁。两类不同的吸毒者占主导：通过多种途径使用甲基苯丙胺的人（51%）和注射海洛因的人（49%）。在多变量逻辑回归中，类别归属与年龄、种族和住房状况有关。艾滋病毒血清呈阳性且报告有过性传播感染的注射毒品者属于甲基苯丙胺类别的几率增加。丙型肝炎病毒呈阳性且报告有过阿片类药物过量的人属于主要注射海洛因类别的几率增加（所有P值<0.05）。
主要注射海洛因的注射毒品者与使用甲基苯丙胺的注射毒品者的风险行为和健康结果有所不同。研究结果表明，在注射毒品者主要使用黑焦油海洛因或甲基苯丙胺的地区，针对注射毒品者亚群体量身定制的干预措施可能会提高效果。
